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目的 探讨经皮肾镜碎石取石术及经尿道输尿管镜碎石术治疗输尿管上段结石的临床疗效.方法 将80例嵌顿性输尿管上段结石或体外冲击波碎石治疗失败的输尿管上段结石患者按照随机数字表法分为A、B两组,各40例.A组给予经皮肾镜碎石取石术治疗,B组给予经尿道输尿管镜碎石术治疗,比较两组围术期情况及术后结石清除率.结果 A组手术时间、术后住院时间显著长于B组(P＜0.01),出血量及住院费用均显著多于B组(P＜0.01),术后3 d及术后1个月A组结石清除率均显著高于B组(P＜0.05或0.01).两组并发症发生率比较差异无统计学意义(P＞0.05).结论 经皮肾镜碎石取石术及经尿道输尿管镜碎石术均是治疗输尿管上段结石的有效方法 ,经皮肾镜碎石取石术结石清除率更高.“,”Objective To investigate the clinical effect of MPCNL and URL in the treatment of upper ureteral calculi. Methods 80 cases with incarcerated upper ureteral calculi or upper ureteral calculi by failed ESWL treatment were randomly divided into group A and B,40 cases in each group. The group A was given MPCNL treatment, group B was given URL treatment, perioperative period condition and postoperative stone clearance rate of the two groups were compared. Results Operation time, blood loss, postoperative hospital stay and hospitalization costs in group A were all significantly more than those in group B(P＜0.01),at 3d and 1 month after operation, stone clearance rate of group A was significantly higher than that of group B (P＜0.05 or 0.01). There was no statistic significance in the complication incidence rate between the two groups (P＞0.05). Conclusion Both MPCNL and URL are effective methods of treatment of upper ureteric calculi, and MPCNL has higher stone clearance rate.